Withdrawal Treatments for Narcotic Addictions

CMS National Coverage Determination | ncd_id=59 | manual_section=130.7 | coverage_level_code=1 | national_coverage_type=True | under_review=False | lab_ncd=False

Withdrawal is an accepted treatment for narcotic addiction, and Part B payment can be made for these services if they are provided by the physician directly or under his personal supervision and if they are reasonable and necessary. In reviewing claims, reasonableness and necessity are determined with the aid of the B/Medicare Administrative Contractor’s medical staff. Drugs that the physician provides in connection with this treatment are also covered if they cannot be self-administered and meet all other statutory requirements.

Cross Reference: Medicare Benefit Policy Manual , Chapter 6, “Hospital Services Covered Under Part B,” §20.4.1 Benefit Categories: 22 - Drugs and Biologicals; 33 - Incident to a physician's professional Service; 52 - Physicians' Services